NATAP: Consumer Reports Fish Oil Supplements

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Subject: NATAP: Consumer Reports Fish Oil Supplements

Consumer Reports- Product Review: Fish Oil and Omega-3 Fatty Acid Supplements (EPA and DHA from Fish, Algae, and Krill)

Initial Posting: 9/24/10 Last Update: 10/3/11 SEE FULL REPORT AT END OF THIS EMAIL BELOW:What CL Found:Among the 24 products that ConsumerLab.com selected for review, only 17 passed quality testing, meeting requirements for freshness and purity, and containing their claimed amounts omega-3 fatty acids. Seven (7) products failed to pass testing for the following reasons:.....Consumer Reports compares fish oil capsules

Updated at 07:38 AM today

December 6, 2011 (WLS) --

Fish oil capsules are now the second most popular supplements. http://abclocal.go.comThe omega-3 fatty acids contained in the capsules can reduce the risk of heart attacks and strokes. Consumer reports tested top-selling brands to see if they met quality standards and were free of contaminants. Walmart's Spring Valley bran offers the best value with the recommended dose costing just seventeen cents per day. A

Consumer Reports medical expert says most people can get sufficient omega-3 fatty acids eating fish like salmon and sardines twice weekly. Consumers

should also check with a doctor before taking fish oil capsules because

they can interact with some prescription drugs.----------------------------Money-saving fish-oil supplementshttp://www.kjrh.comMore and more people are buying fish-oil capsules to reduce the risk of heart attack and strokes. They’re reportedly the most popular supplement after multivitamins. Consumer Reports just tested 15 top-selling brands purchased in the New York metropolitan area to see

whether they contain what they promise and are contaminant-free.All

had the amount of omega-3 fatty acids promised on the label. And the levels of dioxin-like PCBs and other contaminants were below the limits set by the U.S. Pharmacopoeia, a nongovernmental standard-setting group.But

at least one sample of four brands had total PCB levels in amounts that

could require warning labels under a strict California law. Those brands were CVS Natural, GNC Triple Organic, Nature’s Bounty Odorless, and Sundown Naturals. And the coating on Kirkland Signature's enteric-coated capsules didn’t disintegrate properly. That can result in

a fishy aftertaste.But Consumer Reports did find nine brands that met all the quality standards. Of those the least expensive is the Spring Valley brand sold at Walmart. The recommended dose costs just 17 cents a day.The other brands that met all quality standards are Barlean’s Organic Oils EPA-DHA, Carlson Super Omega-3 Gem, Finest Natural, Nature Made, Nature’s Way Fisol, Norwegian Gold Ultimate Critical Omega, The Vitamin Shoppe Meg-3 EPA-DH, and Walgreens Concentrate. Consumer Reports medical advisers say that

omega-3 fatty acids can reduce the risk of heart attacks and strokes and that most people can get enough by eating fatty fish such as salmon or sardines at least twice a week.And Consumer Reports

cautions that fish-oil supplements can interact with certain prescription drugs, including blood pressure medicine, so check with your doctor before taking the supplement.Read more: http://www.kjrh.com/dpp/money/consumer/consumer_reports/money-saving-fish-oil-supplements#ixzz1flXyao80__________________________________Fish Oil Supplement Quality SpottyBy , North American Correspondent, MedPage TodayPublished: December 06, 2011Fish oil supplements can be a bit fishy in terms of quality, according to Consumer Reports magazine.In lab tests of 15 major brands, the magazine said, "six fell a bit short on quality.""In our recent tests, we found that some (supplements) were not as pure as one might think," the magazine's health editor, Ronni Sandroff, said in a statement.But a spokesman for the Council for Responsible Nutrition, an industry group, said the magazine was putting a "negative spin" on what was really a positive report.Fish oil supplements are a booming business, largely because of the health benefits associated with eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), omega-3 fatty acids that can reduce the risk

of heart attacks and strokes.Consumer Reports tested three lots each of the 15 brands to see if they contained the amount of EPA and DHA that they claimed and also to check on levels of lead, mercury, dioxins, or polychlorinated biphenyls.The bottom line, the magazine said, is that "all had their labeled amount of EPA and DHA." As well, none of them had contaminant levels that exceed standards set by the U.S. Pharmacopeia (USP), a nongovernmental agency, or by the European Union.In other words, the products "meet all of their applicable legal and regulatory requirements," said Duffy MacKay, ND, vice-president for scientific and regulatory affairs for the industry group.The report is actually a positive assessment of the tested products, MacKay told MedPage Today.The shortfalls the magazine noted include: Four of the products had at least one sample with PCB levels that could require a warning label under a California consumer law One product had "elevated levels of compounds that indicate spoilage" Two

samples of another supplement failed a test for pills with enteric coatings, suggesting the coatings might dissolve more quickly than intended, leaving a fishy aftertaste Consumer Reports quoted the FDA as saying the agency has not

taken action against any manufacturer for contaminants because it doesn't see a health risk.MacKay said the California law cited by the magazine -- Proposition

65 -- is intended to let consumers know what is in products and has "nothing to do with health-related risk."He noted that the law is "exclusive to California," where he said none of the tested products has been taken off shelves.MacKay also said the magazine used a test for spoilage that is intended to detect a compound called anisidine, but used it on products that were lemon-flavored.The addition of the lemon flavoring causes the test to yield a false positive, he said.-------------------------- Fish and fish oil linked to reduced risk of macular degeneration

consumerreports.org, Mar 15, 2011 4:11 PM

Regularly consuming fish and omega-3 fatty acids found in fish oil might dramatically cut the risk of vision loss from age-related macular degeneration (AMD), according to a study published online this week by the Archives of Ophthalmology.Researchers at Brigham and Women's Hospital and the Harvard Medical School in Boston looked at the eye health and eating habits of 38,022 women in the ongoing Women's Health Study. Over 10 years of follow-up, 235 were diagnosed with AMD. Women who consumed one or more servings of fish per week, and those who regularly consumed the omega-3 fatty acids docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) had a 35 percent to 45 percent reduced risk of clinically significant AMD compared with women who consumed the lowest amounts of fish and omega-3s.

The primary types of fish linked with lower AMD risk were canned tuna, and dark-meat fish such as salmon and sardines. Our recent report on mercury in fish expressed concerns about canned tuna but concluded that Alaskan salmon and sardines were low in mercury.Bottom line: The findings may be the strongest evidence to date that consuming fish and omega-3s help prevent AMD as well as keep it from reaching advanced stages, but they need to be confirmed in randomized clinical trials. That said, fish are rich in protein, vitamin D, and omega-3 fatty acids, which reduce the risk of heart attack and stroke, and might also have other health benefits. If you decide to eat more fish consider lower-mercury choices that are good sources of omega-3 fatty acids.

And if you decide to take a fish-oil supplement, choose one labeled "USP Verified," which indicates that it meets standards for purity and potency set by the U.S. Pharmacopeia, a nongovernmental authority, and have what the USP considers acceptable limits of contaminants. For a list of products that have been verified by the USP, go to www.uspverified.org.--Doug Podolsky, senior editor Consumer Reports - Fish Oil and Omega-3 Fatty Acid Supplements (EPA and DHA from Fish, Algae, and Krill)Update:

Natural Factors — RxOmega-3 Factors:

(12/8/10) CL received a message from a member who had asked Natural Factors about the quality of this product which failed our testing (see report below for details). Our member wrote, “Natural Factors just contacted me to say that they had their product tested by two independent labs in the US and two independent labs in Canada, and they all confirm that the batch ConsumerLab tested did contain 100% of omega-3 -- not 83% as ConsumerLab indicated.”

ConsumerLab.com has no reason to believe that the test results reported by ConsumerLab.com are incorrect. These results are based on the product purchased by CL at retail. The results were confirmed in a second independent laboratory prior to publication, per our protocol.

After publication of our results, Natural Factors contacted CL and initially expressed interest in taking CL up on its retest policy

under which CL sends an unopened, retained sample of the product to a mutually acceptable, independent laboratory for analysis. The requesting

company must agree to publish the results, which we will also publish. Natural Factors, however, did not agree that it would publish the results, so the testing did not occur.

We have not seen the test results alluded to in the message from our member, nor is it clear if these tests were based on a product purchased at retail (like the product we tested) or Natural Factor’s internal reserve samples, which may not reflect real-life conditions experienced by products sold at retail. Storage, transportation and handling can impact the stability and quality of dietary supplements. Properly made products should be designed to deliver their promised ingredients at the time of purchase and throughout the product’s shelf life.

What It Is:

EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) are two principal

fatty acids found in fish and krill. They belong to a family of nutrients known as omega-3 fatty acids. DHA can also be obtained from

other marine sources, such as algae (algal oil). EPA and DHA are polyunsaturated fats ("good" fats, as opposed to saturated fats which are thought to increase the risk of heart disease). The body can only manufacture limited amounts of EPA and DHA from the essential fatty acid, alpha-linolenic acid (ALA) -- found in flaxseed oil, canola oil, soy oil and walnut oil. For more information about ALA see the separate review covering ALA and GLA products.

What It Does:

Cardiovascular Disease:

Omega-3 fatty acids have been most widely studied regarding their effects on cardiovascular health. Increased consumption of fish oil may help slow the progression of atherosclerosis, thereby preventing heart attacks, and reduce the risk of sudden death due to cardiac arrhythmias. A multi-year Dutch study published in 2010, showed a 62% lower risk of fatal heart attack in people consuming even a modest amount of EPA and DHA (about 234 mg per day) from fish as compared to those consuming little (about 40 mg per day of EPA and DHA). The risk of non-fatal heart attacks, however, was not affected (de Goede, J Nutrition, 2010).

The omega-3 fatty acids EPA and DHA have a number of heart-healthy effects, including reducing triglyceride levels, raising levels of HDL ("good") cholesterol and, possibly, "thinning" the blood, reducing levels of homocysteine and reducing blood pressure. Fish oils also appear to enhance the effectiveness of statin drugs used to improve cholesterol profiles. The U.S. Food and Drug Administration (FDA) permits supplements containing omega-3 fatty acids to state: "Supportive

but not conclusive research shows that consumption of EPA and DHA omega-3 fatty acids may reduce the risk of coronary heart disease."

Arthritis and Other Inflammatory Diseases:

Increased intake of the omega-3 fatty acids in fish oil alter the body's production of substances known as prostaglandins, and, consequently, reduce some forms

of inflammation. On the basis of this, EPA and DHA have been tried in the treatment of symptoms of rheumatoid arthritis with considerable success (especially in early stages of the disease). Unlike "disease modifying" drugs, however, fish oil probably doesn't slow the progression of the disease.

The

anti-inflammatory effects of EPA and DHA have also caused researchers to investigate possible benefits of fish oil for the treatment of menstrual cramps, inflammatory bowel disease (ulcerative colitis and Crohn's disease), lupus, and IgA nephropathy. For each of these conditions, at least one double-blind study has found positive results. A

large European study (Hart 2009)

showed that people with the highest consumption of DHA (410 mg to 2,000

mg per day) had a 77% reduction in the risk of developing ulcerative colitis over an average period of four years than those consuming the lowest amount (up to 110 mg per day). Conversely, those consuming the most (15 to 35 grams per day) of linoleic acid (an omega-6 fatty acid) were 2.3 times as likely to develop the disease as those consuming the lowest amount (8 grams - 11 grams per day). However, in Crohn's disease,

a trial of four grams per day of omega-3 fatty acids (50-60% EPA and 15-25% DHA) was ineffective at preventing relapses.

Cancer:

Prevention:

Some evidence suggests that fish oil may reduce the risk of cancer of the prostate, colon/rectum, and breast. The latest evidence relating to breast cancer comes from a prospective study of supplement use and breast cancer risk among postmenopausal women (Brasky, Canc. Epidemiol. Biomarkers Prev 2010). Current

use (but not past use) of fish oil supplements was associated with a 32% reduction in the risk of breast cancer. A specific dose or frequency

of fish oil use associated with the greatest risk reduction was not determined. Risk was greatly reduced for ductal carcinoma of the breast (the most common form of breast cancer), but not lobular carcinoma. This

risk reduction was not seen with other supplements commonly taken for menopausal symptoms (black cohosh, dong quai, soy, or St. 's wort). It

is speculated that the anti-inflammatory property of fish oil may be responsible for an anti-cancer effect because chronic inflammation is associated with cancer initiation and progression. Researchers note, however, that fish oil cannot be recommended for breast cancer prevention without further study. (See the Review of Cancer Prevention Supplements for information about other supplements used for cancer prevention.)

Results

of a prostate cancer prevention study were recently analyzed to determine if blood (serum) levels of omega-3 and -6 fatty acids were associated with prostate cancer. There were no associations with the risk of low-grade prostate cancer but, unexpectedly, elevated levels of DHA (although not EPA, nor EPA plus DHA) were associated with a greater risk of high-grade prostate cancer (Brasky, Am J Epidem 2011).

ConsumerLab.com communicated with the researcher, Dr. Theodore Brasky, to understand the implications. He explained that the study did not reflect supplement use and that a soon-to-be-published study of by him shows no association between fish oil supplement use and prostate cancer

risk. He also noted that other research has found fish consumption to be associated with a large reduction in late state or fatal prostate cancer (Szymanski, Am J Clin Nutr 2010).

Chemotherapy:

Fish oil may prevent weight loss during cancer chemotherapy. Although some trials have not shown a benefit, a recent study (, Cancer 2011)

showed significant benefit. In this study, patients with non-small cell lung cancer took fish oil throughout initial chemotherapy (approximately 10 weeks). During the course of chemotherapy, patients who did not take fish oil experienced an average weight loss of 5 lbs (of which approximately 2.2 lbs was muscle). Those taking fish oil had, on average, no change in weight despite having lost, on average, 6.3% of

their weight over the previous 6 months. In fact, many of those taking

fish oil increased their muscle mass – with the greatest increases corresponding to the greatest increases in plasma EPA concentrations. Cancer response rates to the chemotherapy were similar in the two groups. Patients taking the fish oil were given an option consuming either four 1 gram gelatin capsules per day or 7.5 mL of liquid fish oil

per day. Both formulations provided 2.2 grams of EPA per day.

Eye Disease:

Analyses of dietary intakes taken as part of the Age-Related Eye Disease Study (AREDS) show that participants who reported the highest intake of EPA and DHA were 30% less likely to develop diseases of the retina -- neovascular age-related macular degeneration (AMD) and central

geographic atrophy (CGA) -- compared to those with the lowest intake (SanGiovanni 2009). Decreased

risk of developing AMD was also shown in a study of over 30,000 female health professionals: Those consuming at least one serving per week of fish had a 42% reduction in risk of developing AMD compared to those eating less than one serving per month – and the benefit was greatest with canned tuna or dark-meat fish (e.g., mackerel, salmon, sardines, bluefish, and swordfish) (Christen, Arch Opthamol 2011).

Analyzed another way, the risk of developing AMD in this study was reduced by 38% and 36%, respectively, among those with the highest intakes from their diets of DHA (230 mg median intake) and EPA (100 mg median intake) compared to those consuming the least amount (median intakes of 60 mg of DHA and 10 mg of EPA.) EPA and DHA supplementation are currently being evaluated as treatments for AMD in a related study known as AREDS2. See the Review of Eye Health Supplements for more information about AREDS and AREDS2.

Psychiatric and Mental Disorders:

For reasons that are less clear, omega-3s seem to help depression, bipolar disorder, and schizophrenia according to a limited number of double-blind trials. Fish oil has also been proposed for attention deficit disorder, borderline personality disorder, dyslexia and cognitive impairment, but supporting evidence for these uses remains preliminary.

Depression

A study of depressed older women in a nursing home setting showed that after taking high-dose omega-3 fatty acids for eight weeks (2,500 mg once daily consisting of 1,670 mg EPA and 830 mg DHA), 40.9% had a remission of depression compared to 16.7% of those taking placebo (Rondanelli, J Am Col Nutr 2010). This

study also found a statistically significant improvement in the self-assessed quality of life and that the fish oil treatment was well tolerated. In another

study, the combination of EPA plus the prescription drug fluoxetine (Prozac) was better than either EPA or fluoxetine alone for treating major depression in a short-term (8-week) study of 60 people. However, a

more recent study of people with congestive heart failure and depression failed to show any additional benefit from EPA and DHA when added to treatment with sertraline (Carney, JAMA 2009).

Suicide

An analysis of blood samples from 1,600 military personnel showed those who committed suicide had, prior to suicide, significantly lower blood levels of DHA than personnel

who did not commit suicide (, J Clin Psychiatry 2011). The

population studied was predominantly male and the risk of suicide was found to be 62% greater among men with levels of serum DHA below 1.75% (% of total serum fatty acids) compared to those with higher levels. There was no such relationship with EPA levels. The researchers note that omega-3 fatty acid levels were generally low across the military personnel in the study, much lower than in the general population, and suggested that even greater risk reductions could be possible with higher serum levels of DHA.

Anxiety

A study of U.S. medical students showed, over 12 weeks, that those who received high-dose omega-3 fatty acids (2,496 mg once daily providing 2,085 mg EPA and 348 mg DHA), had a 20% reduction in anxiety symptoms compared to those receiving placebo treatment. Treated students also had a 14% decrease in

a marker of inflammation (stimulated IL-6 production) (Kiecolt-Glaser, Brain Behav Immun 2011).

The study intentionally used an extremely concentrated fish oil (supplied by OmegaBrite) high in EPA due to evidence that EPA has relatively stronger anti-inflammatory and antidepressant effects than DHA.

Pregnancy:

DHA is important for normal development and functioning of the brain and retina

in the fetus and in infants. For this reason, it is thought that pregnant or nursing mothers may benefit from supplementation. DHA is also often added to formula for premature infants and some regular infant formulas and foods. In a recently reported Australian study, pregnant women were given 800 mg of DHA and 100 mg of EPA daily (from 1500 mg of fish oil in capsules) until birth. Compared to women given placebo (vegetable oil capsules), there was no statistically significant increase in cognitive or language

development in offspring during early childhood. Somewhat fewer of the

treated women had postpartum depression (9.67%) than those who received

placebo (11.19%), but this was not statistically significant. However, there was a significant decrease in very premature births (1.09% in the treated group vs. 2.25% in the placebo group) as well as fewer low birth

weight infants and fewer admissions to neonatal intensive care units. There were also fewer fetal/infant deaths among those taking fish

oil, although not by a statistically significant margin. At the same time, more of the treated women were induced or had cesarean sections because they were post term (Makrides, JAMA 2010). A

related editorial recommended that pregnant women should get 200 mg of DHA per day either from a supplement or low-mercury fish and that the benefit of higher intakes remains unclear (Oken, JAMA 2010). Infants

born to women in Mexico given 400 mg DHA daily (from algal oil from Martek Biosciences) during pregnancy (starting at about 20 weeks) had a lower occurrence of colds during the first three month of life than those whose mothers received placebo treatment (37.6% vs. 44.6%, respectively) (Imhoff-Kunsch, Pediatrics 2011).

However, median daily intake of DHA among pregnant women in Mexico is much lower than in the U.S. (80 mg vs. 100 to 200 mg, respectively), so the findings may not apply to groups already consuming higher amounts of

DHA.

Alzheimer Disease and Cognitive Decline:

Population studies suggest that consumption of DHA is associated with reduced incidence of Alzheimer disease and animal studies demonstrate that DHA intake reduces Alzheimer-like brain disease. However, a recent study showed that supplementation with DHA from algae did not slow cognitive and functional decline in individuals with mild to moderate Alzheimer disease (Quinn, JAMA 2010). There

was also no apparent reduction in the decline in brain volume. In the study, patients received 2 grams of DHA from algal oil daily or placebo for 18 months. All of the patients had previously consumed less than 200

mg of DHA per day and had not taken supplements with DHA or EPA. Among those given DHA in the study, plasma levels of DHA tripled and the amount of DHA in cerebrospinal fluid increased by 38%, with no significant change in those taking placebo. It should be noted that the study did not assess whether DHA could play a preventative role in Alzheimer disease, nor did it assess the effect of DHA in conjunction with EPA.

Studies have shown modest benefit with DHA for people with age-related cognitive decline (ARCD). Unlike Alzheimer disease, ARCD is not considered a disease and is a more

gradual and, perhaps, normal consequence of aging. A

6-month study of people over age 65 with mild cognitive impairment showed that those receiving daily fish oil containing a large amount of DHA (1,550 mg) with EPA (400 mg) improved scores on verbal fluency (although not on any other memory or cognition test) compared to those in a control group receiving safflower oil (containing the omega-6 fatty

acid, linoleic acid). An EPA/DHA combination (1,670 mg EPA with 160 mg DHA) did not affect any aspect of cognition or memory. However, both the

EPA/DHA combination and, to a slightly greater extent, the DHA/EPA combination reduced depressive symptoms in these mildly cognitively impaired individuals (Sinn, Br J Nutr 2011).

The researchers note that depression is a potential risk factor for progression to dementia, so the reduction of depressive symptoms may reduce the risk of dementia. In another study (Yurko-Mauro, Alzheimer's & Dementia 2010), participants were given 900 mg per day of DHA from algal oil or placebo for 24 weeks. Those

taking DHA showed significant improvements in verbal recognition memory, but no improvement in working memory or on executive function tests. Plasma DHA levels doubled in the group receiving the supplementation.

Other Diseases:

Other proposed uses of fish oils with some support include asthma, Raynaud's phenomenon (abnormal sensitivity of hands and feet to cold), chronic fatigue syndrome, cystic fibrosis, and osteoporosis.

The balance of current evidence suggests that fish oil is not effective for migraine headaches, multiple sclerosis, psoriasis, male infertility and enhancing

immunity in people with HIV.

Pet Use:

Fish oil supplements are commonly given to pets to help maintain their coats and skin. [Reviews of other pet supplements by ConsumerLab.com include ALA and GLA, Joint Supplements and Multivitamins/Multiminerals.]

For information on dosages see What to Consider When Using.

Quality Concerns and What CL Tested for:

Because omega-3 fatty acids are

obtained from natural sources, levels in supplements can vary, depending on the source and method of processing. Contamination has also

been an issue, because fish can accumulate toxins such as mercury, dioxins, and polychlorinated biphenyls (PCBs). Mercury can damage the nervous system -- particularly in a fetus. Dioxins and PCBs may be carcinogenic at low levels of exposure over time and may have other deleterious effects. The freshness of the oil is also an important consideration because rancid fish oils have an extremely unpleasant odor

and may not be as effective. Additionally, some capsules are enteric-coated and are expected to release the oil after the stomach to theoretically reduce fishy aftertaste or burp. If they release too soon they lose that potential benefit. If they release too late, the oil may not get absorbed. Neither the FDA nor any other federal or state agency routinely tests fish or marine oil supplements for quality prior to sale.

ConsumerLab.com, as part of its mission to independently evaluate products that affect health, wellness, and nutrition, purchased many dietary supplements sold

in the U.S. claiming to contain EPA and/or DHA and tested them for their levels of omega-3 fatty acids (EPA, DHA and, if listed, ALA), mercury, lead, PCBs, and signs of decomposition. Enteric-coated capsules

were tested to see if they properly released their ingredients. One product was additionally tested for dioxins at the request of its manufacturer. Among the products purchased and tested, the majority was for use by people and a few were for use by pets. Most of the supplements were softgel capsules or liquids.

For more information about the testing, see How Products Were Evaluated.

What CL Found:

Among

the 24 products that ConsumerLab.com selected for review, only 17 passed quality testing, meeting requirements for freshness and purity, and containing their claimed amounts omega-3 fatty acids. Seven (7) products failed to pass testing for the following reasons:

Less omega-3 than claimed:

Natural Factors Rx Omega-3 Factors Pharmaceutical Grade contained only 83.3% of the claimed EPA

NOW Neptune Krill Oil contained

only 79.1% of claimed EPA, 76.7% of claimed DHA and 78.4% of the claimed total omega-3 fatty acids, despite showing a "GMP Quality Assured" seal (also failed for spoilage, see below).

The Simpsons Berry Squirts contained only 88.1% of claimed EPA

Spoilage:

Three products were found to be spoiled. While spoilage does not necessarily indicate lower amounts of omega-3's, it indicates elevated levels of spoilage compounds that may cause burping and other gastrointestinal effects. The test for spoilage results in a TOTOX value

which, to be considered fresh, should not exceed a value of 26.

Master Omega-3 (TOTOX = 54.4)

NOW Neptune Krill Oil (TOTOX = 57.4)

wellements PharmaOmega learn (TOTOX = 63.8)

The tests for spoilage were conducted on newly opened products, maintained out of heat and moisture. However, be aware that spoilage may occur after products are opened and exposed to air (see Keeping It Fresh for storage tips).

Enteric-coated pills:

To reduce the likelihood of a fishy aftertaste or burp, some products have enteric coatings designed to release the oil

in the intestine rather than the stomach. ConsumerLab.com tested these coatings in a simulated gastric environment. While several passed the test, Spring Valley Triple Strength Enteric Coated Fish Oil did not. The capsules released oil too early. (See more information at "What to Consider When Buying -- Enteric-coated Pills.")

Contamination:

One product, 1-800-PetMeds Super Omega 3 for Cats and Dogs, exceeded the contamination limit for dioxin-like PCBs (or dl-PCBs, which

are PCBs with established toxicity). It contained slightly more than the 3 picograms per 1,000 milligrams (mg) limit established by the Global Organization for EPA and DHA (GOED). The U.S. FDA has not set a limit. It is unlikely that this exposure alone would cause toxicity, but

it is preferable to avoid unnecessary exposure to toxins. However, bear

in mind that, in comparison to a serving of most fish, even this product contains only a small amount of PCBs.

Several products claimed to be "free of," "void of," or to have "no detectable" PCBs or other contaminants. Be aware that, using highly sensitive standard tests, all fish oil supplements reviewed by CL were found to contain at least trace levels of PCBs and some have trace levels of lead. However, none of these products exceeded contamination limits, other than the pet supplement noted above.

A number of products claimed to be "molecularly distilled." This is a process in which the fish oils are first converted into an ester form and then heated, causing certain other compounds, such as contaminants, to be removed while concentrating the product. Some products make a point of the fact that they are not chemically treated and distilled, such as New Chapter WholeMega, although these products are typically less concentrated for omega-3's. Distillation may also reduce levels of some potentially beneficial compounds (such as small amounts of vitamins) found in fish oil, but this has to be weighed against the benefit of removing contaminants. Other refinement techniques used on fish oils include "winterization" in which the oil is chilled, permitting for separation and removal of saturated fats which naturally occur in fish oil.

None of the products were found to contain detectable levels of mercury [over 10 ppb (parts per billion)]. By comparison, mercury levels in fish

generally range from 10 ppb to 1,000 ppb, depending on the fish (see What to Look for When Buying -- Getting EPA and DHA from Food

for more information). In addition, none of the products contained unsafe levels of lead. A single product (footnoted below with a "D "in the "Purity" column) was additionally tested for dioxins, which can be found in some fish. This supplement did not contain unsafe levels of dioxins. See Testing Methods and Passing Score for more information about how products were evaluated.

There are several possible explanations for the relatively low level of contamination in the supplements: the use of species of fish that are lower on the food chain and, therefore, less likely to accumulate contaminants; the fact that most mercury is found in fish meat and not fish oil; and the use of distillation processesl that remove contaminants. It is worth noting that liver oils may contain higher amounts of contaminants than other fish oils, which are generally made from oils from whole fish. However, the one cod liver oil product tested, Carlson Norwegian Cod Liver Oil, met all quality criteria.

"Fishy" labeling:

To distinguish themselves, some products sport terms which, in actuality, are meaningless:

"Pharmaceutical grade" -- Although some products claim to be "pharmaceutical grade" this term means nothing, as the FDA has not defined what would constitute a pharmaceutical grade fish oil product. In fact, one product which made this claim, Natural Factors Rx Omega-3 failed testing for having less EPA than claimed.

"Tested in FDA approved laboratories" -- The FDA does not approve

analytical laboratories so these claims are not correct, although laboratories may be FDA registered and inspected. In addition, be aware that term "krill oil" in the name of Finest Natural Omega-3 Krill Oil (Walgreens store brand),

is misleading: The side-label on the product shows it to contain twice as much fish oil (300 mg) as krill oil (150 mg). Of the EPA + DHA found in testing only about 12% apparently came from krill oil.

Range of EPA + DHA Concentrations and Pill Sizes:

The concentrations

of EPA and DHA in the pills and liquids can vary by as much as tenfold -- from as little as 8% to over 80% of the fish oil content. Concentration depends on the source of the omega-3's, how the oil is processed, and the amounts of other ingredients included in the supplement. If you are trying to get as much EPA or DHA from the smallest serving size (i.e., fewer or smaller pills or smaller liquid amounts), look for supplements with higher concentrations of EPA and DHA. A more concentrated product will generally allow you to ingest less

total fish oil -- although this may mean saving less than a gram (9 calories) of oil per daily serving. Higher concentrations are not necessarily better for you. You can get the same amount of EPA and DHA from both high and low concentration products as long as you adjust the dose accordingly. To help you compare the concentrations of products, refer to the fifth column in the results table below, which provides the

relative concentration of EPA and DHA in fish or krill oil claimed in each product.

Relative Concentrations of EPA + DHA in Tested Products:

- Extremely high: 80% to 90%

- Very high: 65% to 79%

- High: 45% to 64%

- Moderate: 24% to 44%

- Low: 17% to 23%

- Very low: 8% to 16%

Most of the supplements were softgels and ranged in length from just under one-half inch to over one inch in length. These are fairly large sizes compared to capsules of other types of supplements. If you have trouble swallowing large softgels, the fifth column of the results table

also includes descriptions of the pill size, shape and amount of EPA and DHA per pill or unit. The tested softgels are grouped by length as follows:

Softgel Sizes by Length: (Oblong shape unless noted otherwise)

- Very large: over 25.4 mm (> 1 inch)

- Large: up to 25.4 mm (1 inch)

- Medium/Large: up to 19 mm (3/4 inch)

- Medium: up to 12.7 mm (1/2 inch)

Prices and Value:

To help you compare the cost of products and determine those that offer the best value, the last column of the table below shows the cost to obtain 100 mg of EPA and/or DHA from each product based on the price we paid. After all, it's not how much "oil" that matters, but how much actual EPA and/or DHA you get. Keep in mind that prices may vary and your cost per serving will typically be several times the amount shown in the table depending on how large a dose of EPA and/or DHA you take --

which can range from as little as 100 mg to more than 5,000 mg per day (see Dosage information).

Among fish oil supplements, the cost to obtain 100 mg of EPA and/or DHA varied widely -- from about 1 cent to 15 cents. Higher prices were not associated with higher quality. Krill and algal oils were more expensive, costing about 30 to 60 cents per 100 mg of EPA and/or DHA. A fairly standard daily dose of 500 mg of quality-approved EPA + DHA could

be had for as little as 6 cents from a single softgel of Swanson EFA's Super EPA or 1/3 of teaspoon of NSI Liquid Omega-3 Purified Fish Oil. For a penny more, nearly 700 mg of EPA and DHA was provided by an enteric coated softgel of Kirkland Signature Enteric Coated Fish Oil Omega 3. These

three products are indicated as "Best values" in the table below as they each offered the lowest price among similar products to obtain an equal amount of quality-approved EPA + DHA. Many other good products are

available at reasonable prices and some may offer features such as higher concentrations (permitting smaller pills or liquid amounts) or flavorings.

The quality-approved children's products were moderately priced and were flavored. Dr. Sears Go Fish Strawberry-Lemon Flavor was slightly less expensive than OmegaBrite Kidz (Orange Cream or Tutti Frutti Flavor) for an equivalent dose of EPA + DHA. However, OmegaBrite

was twice as concentrated, so you only need to give a quarter teaspoonful to provide the same amount of EPA + DHA as you would get from a half teaspoonful of the Dr. Sears product. Children can also use other approved products (the taste of fish oil is fairly mild): You can squeeze the oil from a softgel onto a spoon if swallowing a softgel is difficult.

Test Results by Product:

Listed alphabetically below are

the test results for 41 supplements containing omega-3 fatty acids. Twenty-four (24) of these were selected by ConsumerLab.com for review. Seventeen (17) others (each indicated with an asterisk) were tested at the request of their manufacturers/distributors through CL's Voluntary Certification Program

and are included for having passed testing. Also listed is a product similar to one that passed testing but sold under a different brand name.

The full list of ingredients is available for each product by clicking on the word "Ingredients" in the first column. All "Approved" products met their label claims for omega-3's, lacked contamination by mercury, lead and PCBs, was not spoiled, and, if labeled as "enteric coated," passed the relevant disintegration testing. A single product (indicated with a "D" in the second to last column) also passed optional dioxin testing undertaken at the request of the manufacturer/distributor.

RESULTS OF CONSUMERLAB.COM TESTING OF OMEGA-3 SUPPLEMENTS

Click on for additional information on the product

Click on beneath a product name to find a vendor that sells it.

To find retailers that sell some of the listed products click here.

Product Name

Labeled Amount of EPA/DHA per Unit and Suggested Daily Dose on Label

Click on "Ingredients" for Full Listing

Company

(Dist. =

Dist-

ributor

Mfd. =

Manu-

facturer

Amount of EPA and DHA (mg) Per Recommen-

ded Daily Serving (Based on Label)

-- TEST RESULTS --

(See How Products Were Evaluated)

Price

per

100 mg

of

EPA+

DHA14

OVERALL RESULTS:

APPROVED

(Passed)

or

NOT

APPROVED

(Failed)

Contained Claimed Amount of EPA and DHA

Relative Concentration of EPA + DHA1

Claimed Amount of EPA + DHA Per Pill or Unit2

Purity

Did Not Exceed Contamination Limits for Mercury and PCBs

D = Also Tested for Dioxins:

Safe Level Found

Processing Claims

Freshness

(TOTOX

values above 26 indicate spoilage) 13

Softgels:

Advocare OmegaPlex Omega-3 Fatty Acid (300 mg EPA and 200 mg DHA per softgel, 4 per day)

Ingredients

Dist. by Advocare International, L.P.

EPA: 1,200 mg

DHA: 800 mg

APPROVED

High500 mg per very large softgel

4¢

CardioStat Omega-3 Fish Oil Triple Strength (540 mg of EPA and 170 mg of DHA per softgel, 2 per day)

Ingredients

Dist. by Amerifit Brands, Inc.

EPA: 1,080 mg

DHA: 340 mg

APPROVED

Very High710 mg per large softgel

a, 11

Molecularly distilled

5¢

CVS Pharmacy Natural Fish Oil 1000 mg (Label does not show amount of EPA or DHA, but claims 340 mg of total omega-3 fatty acids per softgel, 3 per day)

Ingredients

Dist. by CVS Pharmacy, Inc.

Total

Omega-3: 1,020 mg

Found:

EPA: 507 mg

DHA: 332 mg

APPROVED

Total omega-3 fatty acidsModerateFound 280 mg per very large softgel

11

Molecularly distilled

3¢

Finest Natural Omega-3 Krill Oil (Label does not show amount of EPA or DHA from

krill, but claims 99 mg EPA and 66 mg DHA from fish oil per softgel, 1 to 3 per day)

Ingredients

Dist. by Walgreen, Co.

Found:

EPA: 112 to 337 mg

DHA: 76 to 228 mg

APPROVED

(Note: Name

implies krill

oil, but

contains more

fish oil than krill oil)

HighFound 188 mg per medium/large softgel

a

8¢

Garden of Life Oceans 3 Beyond Omega-3 (337.5 mg EPA and 225 mg DHA per softgel, 2 to 6 per day)*3

Ingredients

Dist. by Garden of Life, Inc.

EPA: 675 to 2,025 mg

DHA: 450 to 1,350 mg

APPROVED

High562.5 mg per large softgel

Molecularly distilled

"No repeat or aftertaste"

7¢

Life Extension Super Omega-3 (350 mg EPA and 250 mg DHA per softgel, 4 per day)*

Ingredients

Dist. by Quality Supplements and Vitamins, Inc.

EPA: 1,400 mg

DHA: 1,000 mg

APPROVED

High600 mg per very large softgel

Molecularly distilled

3¢

Master Omega-3 Natural Lemon Flavor (360 mg EPA and 240 mg DHA per softgel, 2 per day)

Ingredients

Dist. by. Great American Products

EPA: 720 mg

DHA: 480 mg

NOT

APPROVED

High600 mg per large softgel

Spoilage

(TOTOX

value =

54.4)

8¢

Natural Factors RxOmega-3 Factors EPA 400mg/DHA 200 mg (400 mg EPA and 200 mg DHA per softgel, 1 to 3 per day)

Ingredients

Mfd. by Natural Factors, Canada

EPA: 400 to 1,200 mg

DHA: 200 to 600 mg

NOT

APPROVED

Found only 83.3% of claimed EPA

DHAHigh600 mg per very large softgel

11

5¢

New Chapter WholeMega (90 mg EPA and 110 mg DHA per softgel, 2 per day)*

Ingredients

Dist. by New Chapter, Inc.

EPA: 180 mg

DHA: 220 mg

APPROVED

Low200 mg per large softgel

14¢

Nordic Naturals DHA Strawberry Taste (45 mg EPA and 225 mg DHA per softgel, 2 per day)*

Ingredients

Dist. by Nordic Naturals, Inc.

EPA: 90 mg

DHA: 450 mg

APPROVED

Extremely High270 mg per medium/large softgel

D11

Molecularly distilled

10¢

PregnancyPlus Omega-3 (50 mg EPA and 100 mg DHA per softgel, 3 per day)

Ingredients

Dist. by Fairhaven Health, LLC

EPA: 150 mg

DHA: 300 mg

APPROVED

Extremely High150 mg per medium/large softgel

11

Molecularly distilled

13¢

Quest Longevity Omega-3 Complete (400 mg EPA and 200 mg DHA per softgel, 3 per day)

Ingredients

Dist. by SunOpta Inc.

EPA: 1,200 mg

DHA: 600 mg

APPROVED

High600 mg per very large softgel

a

3¢

Res-Q 1250 (390 to 430 mg EPA and 300 to 325 mg DHA per softgel, 4 to 6 per day)5

Ingredients

Dist. by N3 Oceanic, Inc.

EPA: 1,560 to 2,580 mg

DHA: 1,200 to 1,950 mg

APPROVED

Very High690 mg6 per very large softgel

a, 11

3¢

Solgar Omega-3 "950" (542 mg EPA and 408 mg DHA per softgel, 2 per day)*

Ingredients

Dist. by Solgar Vitamin and Herb

EPA: 1,084 mg

DHA: 816 mg

APPROVED

NA950 mg per very large softgel

a

5¢

Swanson EFA's Super EPA (300 mg EPA and 200 mg DHA per softgel, 1 per day)*

Ingredients

Dist. by Swanson Health Products

EPA: 300 mg

DHA: 200 mg

APPROVED

High500 mg per very large softgel

a

1¢

Best value for softgels

Trader Joe's Molecularly Distilled Omega-3 Fatty Acids - Odorless (400 mg EPA and 200 mg DHA per softgel, 1 per day)

Ingredients

Dist. by Trader Joe's

EPA: 400 mg

DHA: 200 mg

APPROVED

High600 mg per very large softgel

Molecularly distilled

Steam deodorized

2¢

Vitamin Shoppe Meg-3 Fish Oil EPA-DHA (300 mg EPA and 200 mg DHA per softgel, 1 to 2 per day)*

Ingredients

Dist. by The Vitamin Shoppe

EPA: 300 to 600 mg

DHA: 200 to 400 mg

APPROVED

High500 mg per large softgel

Molecularly distilled

3¢

Vitamin

World Omega-3 Fish Oil 1000 mg (Label does not show amount of EPA or DHA, but claims 300 mg total omega-3 fatty acids per softgel, 3 per day)*

Ingredients

Mfd. by Vitamin World, Inc.

Total Omega-3: 900 mg

EPA: 473 mg

DHA: 305 mg

APPROVED

ModerateFound 260 mg per large softgel

11

Molecularly distilled

3¢

Weil -- Weil, M.D. Omega- 3 Complex (333 mg EPA and 167 mg DHA per softgel, 1 per day)*

Ingredients

Mfd. by Ideasphere

Total Omega-3: 900 mg

EPA: 333 mg

DHA: 167 mg

APPROVED

NA500 mg per large softgel

a

Molecularly distilled

4¢

Similar to Approved Softgel Products:**

Puritan's Pride Natural Omega-3 Fish Oil 1000 mg (300 mg total omega-3 fatty acids per softgel, 3 per day)

Ingredients

Mfd. by Puritan's Pride, Inc.

Similar to: Vitamin World Omega-3 Fish Oil

Enteric-Coated Softgels:

GNC Triple Strength Fish Oil (647 mg EPA and 253 mg DHA per softgel, 1 per day)*

Ingredients

Dist. by General Nutrition Corporation

EPA: 647 mg

DHA: 253 mg

APPROVED

High900 mg per large softgel

Da, 11

“Purified; controls fishy burps”

3¢

Kirkland Signature Enteric Coated Fish Oil Omega 3 (410 mg of EPA and 274 mg of DHA per softgel, 1 per day)

Ingredients

Dist. by Costco Wholesale

EPA: 410 mg

DHA: 274 mg

APPROVED

High684 mg per very large softgel

11

Molecularly distilled

1¢

Best value for enteric coated softgels

Nature Made Odorless Fish Oil (Label does not show amount of EPA or DHA, but claims 360 mg total omega-3 fatty acids per softgel, 2 to 4 per day)*

Ingredients

Dist. by Nature Made Nutritional Products

Total Omega-3: 720 to 1,440

Found:

EPA: 394 to 787 mg

DHA: 228 to 456 mg

APPROVED

Total omega-3 fatty acidsModerateFound 311 mg per very large softgel

Molecularly distilled

"Odorless, Controls fish burps"

2¢

Olympian Labs Enteric Coated Omega-3 Fish Oils (180 mg EPA and 120 mg DHA per softgel, 2 to 4 per day)

Ingredients

Mfd. by Olympian Labs Inc.

EPA: 360 to 720 mg

DHA: 240 to 480 mg

APPROVED

Moderate300 mg per very large softgel

5¢

Origin Odorless Omega-3 Fish Oil 1200 mg (Label does not show amount of EPA or DHA, but claims 360 mg total omega-3 fatty acids per softgel, 3 per day)

Ingredients

Dist. by Target Corporation

Total Omega-3: 1,080

Found:

EPA: 558 mg

DHA: 405 mg

APPROVED

Total omega-3 fatty acidsModerateFound 321 mg per very large softgel

11

2¢

Spring Valley Triple Strength Enteric Coated Fish Oil (647 mg EPA and 253 mg DHA per softgel, 1 per day)

Ingredients

Mfd. by US Nutrition, Inc.

EPA: 647 mg

DHA: 253 mg

NOT

APPROVED

Failed enteric

coating

testing:

released

ingredients

too soon

High900 mg per very large softgel

2¢

VitalOils Omega-3 Fish Oils (300 mg EPA and 200 mg DHA per softgel, 2 per day)*

Ingredients

Dist. by VitalRemedy- MD, Inc.

EPA: 600 mg

DHA: 400 mg

APPROVED

High500 mg per large softgel

a

Molecularly distilled and winterized

4¢

VitalOils1000 Ultra High Potency Omega-3 Fish Oil (250 mg EPA and 750 mg DHA per enteric coated softgel, 1 per day)

Ingredients

Dist. by VitalRemedy- MD, Inc.

EPA: 250 mg

DHA: 750 mg

APPROVED

Extremely High1,000 mg per large softgel

a

Molecularly distilled

10¢

Liquids:

NSI Liquid Omega-3 Purified Fish Oil (1,572 mg EPA and 1,048 mg DHA per 2 teaspoons (10 mL), twice per day)

Ingredients

Dist. by Nutraceutical Sciences Institute

EPA: 3,144 mg

DHA: 2,096 mg

APPROVED

Moderate1,310 mg per teaspoon (5 mL)

a

1¢

Best value for liquids

Vital Nutrients Ultra Pure Fish Oil "RS" Regular Strength (740 to 825 mg EPA and 460 to 550 mg DHA per teaspoon (5 mL), 1 to 3 per day)

Ingredients

Dist. by Vital Nutrients

EPA: 740 to 2,475 mg

DHA: 460 to 1,650 mg

APPROVED

NA1200 mg6 per teaspoon (5 mL)

5¢

Algal Oil:

Natrol DHA Omega-3 (100 mg DHA per softgel, 1 to 2 per day)4

Ingredients

Dist. by Natrol, Inc.

DHA: 100 to 200 mg

APPROVED

NA100 mg DHA per medium/large softgel

35¢

Cod Liver Oil:***

Carlson Norwegian Cod Liver Oil (400 mg of EPA and 500 mg of DHA per teaspoon (5 mL), 1 per day)*

Ingredients

Dist. by Carlson Division of J.R. Carlson Laboratories, Inc.

EPA: 400 mg

DHA: 500 mg

APPROVED

Low900 mg per teaspoon (5 mL)

a, 11

6¢

Krill Oil:

(Also see "Finest Natural Omega-3 Krill Oil" in Softgels section above. Additionally, two krill oil ingredients have been tested and approved for quality through ConsumerLab.com’s Raw Materials Testing Program.)

Mercola Premium Select Krill Oil (45 mg EPA and 25 mg DHA per gelatin caplique, 2 per day)*

Ingredients

Dist. by Mercola.com

EPA: 90 mg

DHA: 50 mg

APPROVED

Very Low70 mg per medium/large caplique

a

59¢

NOW Neptune Krill Oil (75 mg EPA and 45 mg DHA per softgel, 2 per day)

Ingredients

Mfd. by NOW Foods

EPA: 150 mg

DHA: 90 mg

NOT

APPROVED

Found only 79.1% of claimed EPA and 76.7% of claimed DHA

Also found only 78.4% of claimed total omega-3 fatty acids Moderate120 mg per medium/large softgel

11

Spoilage

(TOTOX

value =

57.4)

28¢

Source Naturals Arctic Pure Krill Oil (75 mg EPA and 45 mg DHA per softgel, 2 per day)

Ingredients

Dist. by Source Naturals, Inc.

EPA: 150 mg

DHA: 90 mg

APPROVED

Moderate120 mg per medium/large softgel

a

31¢

Children:

Dr. Sears Go Fish Strawberry- Lemon Flavor (212 mg EPA and 370 mg DHA per ½ teaspoon (2.5 mL), 1 per day)7

Ingredients

Dist. by Right Track Global, LLC

EPA: 212 mg

DHA: 370 mg

APPROVED

Low582 mg per ½ teaspoon (2.5 mL)

a, 11

"Highly refined oil"

"No fishy taste or smell"

4¢

OmegaBrite Kidz Orange Cream Flavor (475 mg EPA and 112 mg DHA per ¼ teaspoon (1.25 mL), 1 per day)*8

Ingredients

Dist. by OmegaBrite

EPA: 475 mg

DHA: 112 mg

APPROVED

High587 mg per ¼ teaspoon (1.25 mL)

a, 11

Molecularly distilled"

"Fish oil odor or aftertaste eliminated"

5¢

OmegaBrite Kidz Tutti Frutti Flavor (475 mg EPA and 112 mg DHA per ¼ teaspoon (1.25 mL), 1 per day)*8

Ingredients

Dist. by OmegaBrite

EPA: 475 mg

DHA: 112 mg

APPROVED

High587 mg per ¼ teaspoon (1.25 mL)

a, 11

Molecularly distilled"

"Fish oil odor or aftertaste eliminated"

5¢

The Simpsons Berry Squirts (55 mg EPA and 35 mg DHA per softgel, 2 per day)

Ingredients

Dist. by St. Hill Pharmaceutical Corporation

EPA: 110 mg

DHA: 70 mg

NOT

APPROVED

Found only 88.1% of claimed EPA

DHA

Also found only 89% of claimed total omega-3 fatty acids and 83% of claimed total omega-7 fatty acids claimed Moderate90 mg per large softgel

a

18¢

Wellements PharmaOmega learn (250 mg EPA and 100 mg DHA per softgel, 2 per day)

Ingredients

Dist. by Wellements LLC

EPA: 500 mg

DHA: 200 mg

NOT

APPROVED

Very High350 mg per medium/large softgel

a

"Ultrarefined and distilled"

Spoilage

(TOTOX

value =

63.8)

9¢

Pet:

1-800-PetMeds Super Omega 3 for Cats and Dogs (180 mg EPA and 120 mg DHA per softgel, 1 per day)9

Ingredients

Dist. by 1- 800-PetMeds

EPA: 180 mg

DHA: 120 mg

NOT

APPROVED

Moderate300 mg per large softgel

Exceeded limit for dioxin-like PCBs

(Found 3.14 pg/g)12

4¢

Shiny Coat for Dogs and Cats (1,109 mg EPA and 705 mg DHA per teaspoon [5 mL], 1/8 to 1 teaspoon per day)10

Ingredients

Dist. by Liquid Solutions

EPA: 139 to 1,109 mg

DHA: 88 to 705 mg

APPROVED

NA1,814 mg per teaspoon (5 mL)

2¢

* Tested through CL's Voluntary Certification Program prior to, at time of, or after initial posting of this Product Review.

** Product identical in formulation and manufacture to a product that has passed testing but sold under a different brand. For more information see CL's Multi-Label Testing Program.

*** Be aware that cod or other fish liver oils are not always a good substitute for fish oil supplements as these may be high in vitamins A and D. Because these vitamins can be toxic, make sure that

you do not exceed safe levels (see Multivitamin Product Review for Tolerable Upper Intake Levels (ULs) for vitamins and minerals). The one cold liver oil product listed in this review provided safe levels of vitamins A and D.

NA = Not Available. Did not list amount of fish oil, so concentration (calculated as EPA+DHA /fish oil) cannot be determined.

D = Product participated in optional dioxin testing at the request of its manufacturer/distributor through CL's Voluntary Certification Program and met WHO (World Health Organization) recommendations for dioxins.

- Canadian product.

a Some people are allergic to proteins in fish and krill (among other foods). Products are required to identify foods with allergic potential (including the species name) with a statement, e.g., "Contains: Fish (mackerel)." Not all of the fish oil products tested provided this complete labeling (those that did not have been indicated with a footnote in the sixth column in the results table above). It is possible that some manufacturers did not include this labeling because they considered the oil to be highly refined (and contain minimal protein). In any event, if you have an allergy to fish or krill, be cautious with products made of their oils, even if highly refined.

1 Concentration (wt/wt) of EPA + DHA in fish and/or krill oil claimed in product. See Range of EPA + DHA Concentrations and Pills Sizes for more information.

2 For softgel sizes see Range of EPA + DHA Concentrations and Pills Sizes.

3 Label reads: 1 softgel/day for children 4 & up.

4 Label reads: Take 1 softgel, one time daily, with a meal. Pregnant/Lactating Women: After consulting with your physician, take 1 softgel, two times daily.

5 Label reads: Adults take 4-6 capsules daily. Take 2-3 capsules a half-hour prior to a meal and 2-3 capsules before bedtime.

6 Calculated from minimum claimed EPA and DHA.

7 Label reads: As a dietary supplement for children 6 months and older, take 1/2 teaspoon (2.5 mL) daily or as directed by your health care professional. Ages 13 and older may double the dosage.

8 Label reads: Children (age 6 and up) dose: Take

1/4 teaspoon daily, with a meal. Adult dose: Take 1/2 to 1 teaspoon daily, with a meal.

9 Label reads: For every 50 lbs. of body weight, or fraction thereof: 1 capsule daily.

10 Label reads: Dogs 0-20 lb 1/8 tsp, 21-50 lb 1/4 tsp, 51-100 lb 1/2 tsp, 100+ lb 1 tsp. Cats 1/8 tsp.

11 Product claimed to be "free of," "void of," or

to have "no detectable" PCBs or other contaminants. Be aware that, using highly sensitive standard tests, all fish oil supplements reviewed

by CL were found to contain at least trace levels of contaminants. However, this product did not exceed strict contamination limits applied by CL.

12 ConsumerLab.com applied same contamination limits for products for human consumption to products for pet consumption.

13 TOTOX is a measure of spoilage (rancidity). TOTOX values above 26 indicated spoilage.

14 Based on price paid by ConsumerLab.com (which purchased products as a consumer would) and amounts of EPA + DHA noted in the fifth column. Prices may vary.

Unless

otherwise noted, information about the products listed above is based on the samples purchased by ConsumerLab.com (CL). Manufacturers may change ingredients and label information at any time. So be sure to check labels carefully when evaluating the products you use or buy. If a

product's ingredients differ from what is listed in this report, it may

not be the same as what was tested.

The information contained in this report is based on the compilation and review of information from product labeling and analytical testing. CL applies what it believes to be the most appropriate testing methods and standards. The information in this report does not reflect the opinion or recommendation of CL, its officers or employees. CL cannot assure the accuracy of information provided to it by third parties. Liability to any person for any loss or

damage caused by errors, omissions, or inaccuracies in this report is hereby disclaimed.

Copyright

ConsumerLab.com, LLC, 2010. All rights reserved. Not to be reproduced, excerpted, or cited in any fashion without the express written permission of ConsumerLab.com LLC.

ConsumerTips:

What to Consider When Buying:

Getting EPA and DHA From Supplements:

When buying supplements containing EPA and/or DHA, keep in mind that products vary significantly in terms of the amounts and ratios of EPA and DHA. Be aware that only about a third of the oil from fish is EPA and DHA, although this may be higher (up to about 85% as EPA and DHA) in a "concentrated" product". Second, the ratio of EPA to DHA will vary. Products made from menhaden and other

small oily fish, for example, tend to have a ratio of EPA to DHA of 1.5:1 so that a capsule claiming 1 gram (1,000 mg) of fish oil, of which

30% is EPA and DHA, provides 180 mg of EPA and 120 mg of DHA. Salmon oil naturally contains more DHA than EPA (often several times more) and products made only from algal oil will contain only DHA. With a more concentrated product, one may be able to take fewer capsules of the same

size. Semi-synthetic ("ester") forms of EPA and DHA are also available and are believed to be as active as the natural ("triacylglycerol") forms -- although a preliminary study in rats suggests that their actions may not be identical.

Many products also contain vitamin E or other antioxidants to stabilize the oils and prevent them from becoming rancid.

Your daily intake should be based on your reason for taking it (see below) and the amount that you are already getting from your diet.

To avoid contaminants in an unrefined supplement, it's best to choose those made from small, oily fish that are low in food chain, such as anchovy, sardines or menhaden. Also be aware that fish "liver" oils can contain high levels of vitamins, such as vitamin A, which can be toxic at excessive doses (see Concerns and Cautions below for more information).

Algal Oil

Algae, which are aquatic plant-likes

organisms, are a source EPA and DHA. Algal oil supplements currently on

the market principally provide DHA derived from microalgae. If you are primarily interested in DHA or are vegetarian, algal oil supplements are

a good option and they are typically very low in contaminants since algae is low on the food chain.

Krill Oil

Like fish oil, oil from krill (a shrimp-like crustacean) contains significant amounts of both EPA and DHA. It also contains phospholipids and astaxanthin.

Preliminary studies indicate that krill oil, like fish oil, has a beneficial effect on cholesterol and triglyceride levels and anti-inflammatory applications. See the article on Krill Oil

in the Encyclopedia. It has been suggested that the phospholipids in krill oil enhance absorption of its EPA and DHA, although this has not been established.

Krill is a primary food source for certain whales, seals, penguins and other animals. It's harvesting has been a subject of environmental debate. Proponents of the use of krill oil in supplements argue that it is plentiful and only a small percentage of total krill biomass is being

harvested, most of which is used in fish meal and not for direct human consumption. There are also catch limits for sustainable exploitation established by a conservation commission known as CCAMLR, and registration and monitoring is required of harvesting vessels. However, other groups, such as the Antarctic Krill Conservation Project

counter that krill harvesting may have detrimental effects on sea life and on other animals that depend directly or indirectly on krill, and that current limits and monitoring are insufficient.

Enteric-coated pills:

Some fish oils come in enteric-coated pills, designed to release the oils in the intestine rather than the stomach -- to help avoid fishy aftertaste or fishy smelling burps. As long as these pills release on time, this should not compromise your absorption of omega-3's because oils are not absorbed in

the stomach, but in the intestine. With the help of bile acids, oils get emulsified (made into smaller droplets) in the upper intestine so they can be more effectively acted on by pancreatic lipase (an enzyme) and absorbed further down the small intestine. If this doesn't happen, less oil may be absorbed.

So while enteric-coated pills may be fine, if you notice more oily stools, this would be an indication that the oils are not being well absorbed. Also be aware that some of these enteric coatings are made with acrylics (such as methacrylic acid copolymer) that don't break down

-- they are like thin latex balloons intended to pop open under specific conditions (they are also somewhat stiffer than regular softgels). You might find remains of these pills in your stool, but there is no reason to be concerned.

Unfortunately, as we found in this review, one enteric coated product failed to pass testing by releasing its ingredients too early. You will still get omega-3's from such a product, but may not get the expected reduction in fish odor.

Getting EPA and DHA From Food:

You may want to consider getting omega-3 fatty acids directly from fish. For the general population, the American Heart

Association (AHA) recommends at least two 3 oz servings of fish per week. For people with heart disease or cardiac risk factors, some experts recommend eating four 3-ounce servings of fatty fish per week. Fatty fish, such as the following, have higher levels of omega-3 fatty acids:

Anchovies

Bluefish

Carp

Catfish

Halibut

Herring

Lake trout

Mackerel

Pompano

Salmon *

Striped Sea Bass

White Tuna (Albacore) **

Whitefish

Source: U.S. Department of Agriculture, Agricultural Research Service. 2001.

* Farmed salmon may contain more PCBs than other salmon.

** May contain an excessive amount of mercury. Total

amounts of omega-3's vary among fish, but ones listed above are all good sources. A three-ounce serving (half a can) of canned albacore "white" tuna, for example, contains about 2.5 grams of fat, about 30% of

which is EPA (200 mg) and DHA (500 mg). "Light" tuna, contains less than half the omega-3 oils of "white" tuna. A three-ounce serving of canned salmon contains about 4.5 grams of fat of which 17% is EPA (166 mg) and DHA (587 mg).

Eggs fortified with DHA are also available in the U.S. and claim to contain about 150 mg of DHA in each egg. Chickens producing these eggs are typically fed algal DHA. Algal DHA is also an approved food ingredient, so that foods and beverages can be fortified with DHA and be

considered vegetarian. Because some formula-fed infants may not be converting enough ALA to DHA, some formulas are also available with DHA -- which has been added to formulas for premature infants for many years.

Amounts of EPA and/or DHA in fortified foods and beverages tend to be about 50 to 100 mg per serving -- much lower than that found in a serving of fish or in a traditional fish oil supplement. While omega-3 fortified products can contribute to your intake of these fatty acids, they are typically not sufficient in themselves to provide the full generally recommended amounts of EPA or DHA. Be aware that ConsumerLab.com found, in the past, that some fortified foods or beverages claimed to supply certain percentages of a "Daily Value" of EPA and DHA (which they claimed to be160 mg of EPA and DHA). Such statements are not correct. A "Daily Value" for omega-3 fatty acids has not been established.

Contaminants in Fish vs. Supplements

Levels of pollutants, such as mercury, tend to be higher in long-lived, larger fish, particularly shark, swordfish, king mackerel, and tilefish.

These fish tend to average about 1,000 ppb (parts per billion) of mercury -- the FDA limit for human consumption -- while most other fish tend to have about one-tenth to one-third of this amount. Eating a fish with 1,000 ppb of mercury is not necessarily toxic, but it should not be

consumed by young children and pregnant or nursing women, or by anyone on a regular basis. The Environmental Protection Agency (EPA) has also advised that fresh-water fish may contain more mercury than commercially

caught fish and advises that "If you are pregnant or could become pregnant, are nursing a baby, or feeding a young child, limit consumption of fish caught by family and friends to one meal (about 6 ounces) of fish per week." The same limit is recommended for albacore ("white") tuna, as it may occasionally contain excessive levels of mercury.

PCBs occur in nearly all fish oil supplements at extremely low levels (under 3 picograms per gram), as shown in our testing. You are likely to

get a much higher amount of PCBs from eating fish. A study of fish sold

in markets in Germany, for example, showed oily fish (such as salmon) to contain about 2 picograms of dioxin-like PCBs (dl-PCBs) per gram (Karl, J.Verbr. Lebensm 2008). A small serving (3 ounces or 85 grams) of salmon, therefore, would contain about 170 picograms of dl-PCBs, which is more than 50 times

the amount in a one gram serving of even the most contaminated fish oil

in this review (which happened to be a pet supplement). Even a serving of less oily fish (which tend to have fewer PCBs but also less omega-3s)

is likely to contain several times more PCBs than a typical fish oil supplement.

If you are concerned about mercury and other potential contaminants, concentrated fish oil products may be a better choice, provided that they contain the claimed amount of oils and meet other quality parameters tested for in this review.

Omega-3 vs. Omega-6 Fatty Acids:

Some experts suggest that the American diet contains too little omega-3 fatty acids and too much of another essential fatty acid family called the omega-6 fatty acids. Omega-6's are found in oils from corn, sunflower, soy, peanut and other plants. The typical ratio of omega-6's to omega-3's in the American diet

is believed to be as high as 14:1 (14 grams of omega 6's for every gram

of omega-3's); these experts suggest that a ratio of no more than 3:1 (3 grams of omega-6's for every 1 gram of omega-3) may be preferable. However, the evidence for this recommendation is sketchy at best.

What to Consider When Using:

Dosage:

In the U.S., there is no official recommended

intake for EPA and DHA in healthy people. However, some other countries

recommend from 300 mg to 500 mg per day of a combination of EPA and DHA. This is roughly equivalent, if not greater than, the amount of omega-3's obtained from two servings of fish per week, as suggested by the American Heart Association (See Getting EPA and DHA from Food).

For reducing the risk of coronary events

(such as heart attacks) among people with coronary artery disease (CAD), the same general recommendation holds true. A recently reported study in Norway among CAD patients showed only those with intakes lower than 300 mg per day of omega-3 fatty acids had a slightly increased risk

of coronary events. There was no significant difference in risk among groups with high (580 mg), very high (1,360 mg) or even extremely high (2,640 mg) daily intakes of omega-3's (Manger, Am J Clin Nutr 2010).

A typical dose of fish oil for specific therapeutic uses is 6-12 grams daily. However, as noted above, EPA and DHA represent only part of the total oil in fish and their levels vary among products. For most therapeutic uses of omega-3s, the daily dosage of total EPA and DHA tested in studies has ranged from 1-6 grams daily. Higher dosages have been tried by some researchers, especially for the treatment of schizophrenia, Raynaud's phenomenon, and lupus.

The American Heart Association recommends fish oil capsules for patients with extremely high triglycerides (greater than 1,000 mg/dL), who have not responded well to

other treatments. In treating patients with high triglycerides, about 5

grams of combined EPA and DHA is recommended daily. Due to this large dose, physicians typically recommend using a highly concentrated fish oil product. A prescription fish oil, Lovaza, provides 840 mg of EPA and

DHA per 1 gram capsule (an 84% concentration), of which approximately 465 mg is EPA and 375 mg is DHA. Similarly high concentrations can be found among dietary supplements (see results table above

for products listed as "Extremely high" in concentration in the fifth column), although such products may be designed as smaller softgels with

smaller doses. In any event, multiple pills will be needed, so an alternative is a highly concentrated liquid, where a couple of teaspoons

full can supply the proper dose.

As little as one gram daily of combined EPA and DHA may be adequate for reducing risk of a recurrent heart attack.

For pregnant and nursing women, the recommended dose of DHA, from either supplements or fish, is 100 to 200 mg per day. 400 mg DHA daily has been shown to reduce colds during initial months of infancy among women with otherwise low DHA intake (Imhoff-Kunsch, Pediatrics 2011).

For potentially reducing the risk of developing of retinal disease, consumption of approximately 200 mg or more of EPA and DHA per day may be helpful. This is based on the dietary

intakes of participants in the AREDS study who had the lowest incidence

of retinal disease. A

separate study suggests benefit with consumption of at least one serving of fish per week, particularly canned tuna or dark-meat fish (salmon e.g., mackerel, salmon, sardines, bluefish, and swordfish), which works out to consumption from the diet of about 100 mg of EPA and 230 mg of DHA per day (Christen, Arch Opthamol 2011). In

the AREDS2 study, which is currently underway, researchers have chosen to test the effect of a daily supplement containing 650 mg of EPA and 350 mg of DHA. (See What It Does: Eye Disease, above, for more information).

For maintaining weight during initial chemotherapy, fish oil providing 2.2 grams of EPA per day (, Cancer 2011).

For depression, 2,500 mg (consisting of 1,670 mg EPA and 830 mg DHA) taken once daily for eight weeks (Rondanelli, J Am Col Nutr 2010). In

mildly cognitiviely impaired individuals, combinations providing either

1,550 mg DHA with 400 mg EPA or 1,670 EPA with 160 mg DHA have also shown benefit over 6 months (Sinn, Br J Nutr 2011). Also, 1,000

mg per day of EPA together with the prescription drug fluoxetine (Prozac) appears to be more effective than either EPA or fluoxetine alone.

For anxiety, 2,496 mg once daily (providing 2,085 mg EPA and 348 mg DHA), taken once daily (Kiecolt-Glaser, Brain Behav Immun 2011).

Fish

oils are best tolerated when taken with meals, and, if possible, should

be taken in divided doses, i.e., divide the dose in half and take twice

daily, or in thirds and take three times a day.

Keep It Fresh:

Omega-3 fatty acids can spoil, so it is best to keep products out of heat and light. Once opened, tightly reseal the container. If possible, refrigeration can help prolong freshness and is particularly important with bottled liquids. A slight cloudy appearance of the oil is normal after refrigeration -- just shake the bottle before use. If you use a bottled liquid, purchase a size that you will completely use within a few weeks because once air is introduced into the bottle, spoilage may begin.

About the California Law Suit Over PCBs in Fish Oil Supplements:

A lawsuit was filed on March 2, 2010 by a group that tested ten fish oil supplements and found that all violated California's Prop 65 labeling requirement because they contained PCBs. While it raises legitimate concerns, the suit may have created some confusion. Here are some points to keep in mind:

As noted in our report, virtually

all fish meat and fish oil supplement will contain some PCBs. The samples chosen in the suit were oils made primarily from larger fish (including shark) and fish liver, which tend to have higher amounts of contaminants if not well refined.

The majority of the products

had extremely low levels of PCBs. Somewhat higher levels were found in a

few products. None of these pose a health risk in themselves, but those

with higher levels might unnecessarily contribute to PCB exposure. The products are identified by name in a news release about the suit which includes two tables. The first table shows total PCBs. The second table shows the amount of dioxin-like

PCBs (dl-PCBs), which may be more meaningful as it focuses on the subset of PCBs known to be harmful in animal studies. Be aware that results in both tables are skewed against products that suggest higher daily serving sizes as they show PCBs per daily serving, rather than per

gram.

To put the findings in perspective, only 2 of the 10 products exceeded 3 picograms of dl-PCBs per daily serving. One was from cod liver oil and the other from shark liver oil. Looking at all types of PCBs (not just dl-PCBs), daily amounts were under 100 nanograms for most supplements and did not exceed

900 nanograms for any. The FDA permits a 3 ounce serving of fish to contain about 169,000 nanograms of total PCBs, 188 times more than in any of the products. The EPA, using a more conservative approach, estimates that the average adult can consume 1,400 nanograms of total PCBs per day without harmful effects. [1 nanogram = 1,000 picograms]

One of the products, Nature Made Odorless Fish Oil,

was also tested by ConsumerLab.com for this review. The suit showed only 0.14 picograms of dl-PCBs per daily serving (2,400 mg) equaling just 0.06 picograms per gram. This is well below the GOED limit of 3 picograms per grams (as well as below the European limit of 6 picograms per gram), as we also found.

Concerns and Cautions:

While fish oil supplements are generally considered safe, there are a few caveats and cautions you should take into consideration before you buy. While krill oil has not been as extensively studied as fish oil, it is reasonable to assume that the same concerns and cautions apply.

The most common side effects are fishy smelling burps and diarrhea.

Up to about 20 grams of fish oil can be well tolerated by most adults. However, such high amounts may not be beneficial and the FDA recommends that consumers not exceed more than a total of 3 grams per day of EPA and DHA omega-3 fatty acids, with no more than 2 grams per day from a dietary supplement.

Be aware that cod or other fish liver oils are not always a good substitute for fish oil supplements as these may be high in vitamins A and D. Because these vitamins can be toxic, make sure that you do not exceed safe levels (see Multivitamin Product Review for Tolerable Upper Intake Levels (ULs) for vitamins and minerals).

The only significant safety concerns regarding fish oil involve its apparent "blood thinning" effect. On this

basis, fish oil should be used only under a physician's care by people with bleeding disorders such as hemophilia, those taking strong prescription blood thinners, such as Coumadin (warfarin) or heparin, and

those expecting to undergo surgery.

If you take blood pressure lowering medication, be aware that fish oil may further lower blood pressure.

High doses (over 3 grams per day) of fish oil may suppress the immune system. Unless medically necessary, such doses should be avoided, particularly by immunocompromised individuals.

Contrary to earlier reports, fish oil does not appear to adversely affect blood sugar levels in people with diabetes.

Some people are allergic to proteins in fish and krill (among other foods). Supplements are required to identify

foods with allergic potential (including the species name) with a statement, e.g., "Contains: Fish (mackerel)." Not all of the fish oil products tested provided this complete labeling (those that did not have

been indicated with a footnote in the sixth column in the results table

above). It is possible that some manufacturers did not include this labeling because they considered the oil to be highly refined (and contain minimal protein). In any event, if you have an allergy to fish or krill, be cautious with products made of their oils, even if highly refined.

See the Encyclopedia for more information about clinical studies on Fish and Marine Oil (Omega-3) as well as Krill Oil.

To further assist consumers, ConsumerLab.com licenses its flask-shaped CL Seal of Approved Quality (see The CL Seal)

to manufacturers for use on labels of products that have passed its testing. ConsumerLab.com will periodically re-evaluate these products to

ensure their compliance with ConsumerLab.com's standards.

Information on this site is provided for informational purposes only. It is not an endorsement of any product nor

it is it meant to substitute for the advice provided by physicians or other healthcare professionals. The information contained herein should not be used for diagnosing or treating a health problem or disease.