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Medical Forum / Diseases and Disorders / Prostate Cancer / April 2007How Much Fish Oil?
How much fish oil supplements do you take a day? wsf > How much fish oil supplements do you take a day? Three 1-gm capsules. Or I just take a small swig from a bottle of it, or pour a "dose" on salad or into the olive oil I dip my bread into. We need 3-4 grams a day if our objective is to lower our triclycerides. I'll find out next week how much good it might be doing in that regard. I.P. > How much fish oil supplements do you take a day? Prescription OMACOR 1-gram gel caps (EPA and DHA) Two in the morning and two in the evening. >> How much fish oil supplements do you take a day? > > Prescription OMACOR 1-gram gel caps (EPA and DHA) > Two in the morning and two in the evening. Sorry to intrude here again although I don't have PCa. But I'm a guy and naturally a bit worried about getting PCa, and therefore check this group now and then, I'm a cancer patient though, dxd with throat cancer 18 years ago. I have my doubts about OMACOR's suitability for cancer patients. According to <http://www.omacorrx.com/OMACOR/OMACOR_Prescribing_Information.pdf> it contains omega-3 fatty acids EPA and DHA in ethyl ester form. That form is relatively cheap to manufacture and it may be well suited to reduction of triglycerides and secondary prevention of coronary heart disease - as are other forms of fish oil. But fish oil does not appear in nature in ethyl ester form, but in triglyceride form. The animal study Hudson EA, Tisdale MJ. Comparison of the effectiveness of eicosapentaenoic acid administered as either the free acid or ethyl ester as an anticachectic and antitumour agent. Prostaglandins Leukot Essent Fatty Acids. 1994 Aug;51(2):141-5. PMID: 7972268 [PubMed - indexed for MEDLINE] <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstra ctPlus&list_uids=7972268> suggests that ethyl ester form of EPA is inferior to EPA as free fatty acid in cancer: "A comparison has been made of the effectiveness of eicosapentaenoic (EPA) acid administered as either the free acid or the ethyl ester as an anticachectic and antitumour agent in mice bearing an experimental cachexia-inducing tumour (MAC16 colon adenocarcinoma). While the free acid of EPA was effective in reversing host body weight loss and inhibiting tumour growth the ethyl ester was ineffective in either respect at the same dose level, even when administered with a high fat diet. The lack of effectiveness of the ethyl ester correlated with the inability to reach effective plasma and tumour concentrations of EPA over the initial time period. Whereas effective plasma concentrations of EPA were achieved within 24 h after administration of the free acid, a time lapse of 96 h was required with the ethyl ester, even when combined with a high fat diet. Due to the acuteness of the MAC16 model this time is too long for a therapeutic benefit to be realized." Also, the bioavailability of ethyl ester form of fish oil is inferior to the bioavailability of the free fatty acid and the natural triglyceride forms: Omega-3 fatty acid - Wikipedia, the free encyclopedia <http://en.wikipedia.org/wiki/Omega-3_fatty_acid> "... Of four studies that compare bioavailability of the triglyceride form of fish oil vs. the ester form, two have concluded that the natural triglyceride form is better, and the other two studies did not find a significant difference. No studies have shown the ester form to be superior although it is cheaper to manufacture. ..." Visioli F, Rise P, Barassi MC, Marangoni F, Galli C. Dietary intake of fish vs. formulations leads to higher plasma concentrations of n-3 fatty acids. Lipids. 2003 Apr;38(4):415-8. PMID: 12848287 [PubMed - indexed for MEDLINE] <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstra ctPlus&list_uids=12848287> "The n-3 fatty acids from fish appear to be more efficacious, in terms of cardioprotection, than equivalent amounts provided as capsules. Volunteers were given, for 6 wk, either 100 g/d of salmon, providing 383 mg of EPA and 544 mg of DHA, esterified in glycerol lipids, or 1 or 3 capsules of fish oil/d, providing 150 mg of EPA and 106 mg of DHA or 450 mg of EPA and 318 mg of DHA, as ethyl esters. Further, we reevaluated data from a previous study carried out with the same design, i.e., with 3 and 6 capsules/d of fish oil, providing 1290 and 2580 mg/d EPA and 960 and 1920 mg/d DHA. Marked increments in plasma EPA and DHA concentrations (microg/mg total lipid) and percentages of total fatty acids were recorded at the end of treatment with either n-3 capsules or salmon. Net increments of EPA and DHA in plasma lipids were linearly and significantly correlated with the dose after capsule administration. Further, increments in plasma EPA and DHA concentration after salmon intake were significantly higher than after administration of capsules. The same increments would be obtained with at least two- and ninefold higher doses of EPA and DHA, respectively, if administered with capsules rather than salmon. We provide experimental evidence that n-3 fatty acids from fish are more effectively incorporated into plasma lipids than when administered as capsules and that increments in plasma concentrations of EPA and DHA given as capsules are linearly correlated with their intakes." Lawson LD, Hughes BG. Human absorption of fish oil fatty acids as triacylglycerols, free acids, or ethyl esters. Biochem Biophys Res Commun. 1988 Apr 15;152(1):328-35. PMID: 3358766 [PubMed - indexed for MEDLINE] <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstra ctPlus&list_uids=3358766> "The transient rise in plasma triacylglycerol fatty acids after single-dose ingestion of fish oil as triacylglycerols, free acids, or ethyl esters with linseed oil as an absorption standard was used to determine the relative absorption of fish oil fatty acids in eight men. As free acids, the fish oil fatty acids were well absorbed (greater than or equal to 95%). As triacylglycerols, eicosapentaenoic acid (1.00 g) and docosahexaenoic acid (0.67 g) were absorbed only 68% and 57% as well as the free acids. The ethyl esters were absorbed only 20% and 21% as well as the free acids. The incomplete absorption of eicosapentaenoic and docosahexaenoic acids from fish oil triacylglycerols correlates well with known in vitro pancreatic lipase activity." Beckermann B, Beneke M, Seitz I. [Comparative bioavailability of eicosapentaenoic acid and docasahexaenoic acid from triglycerides, free fatty acids and ethyl esters in volunteers] Arzneimittelforschung. 1990 Jun;40(6):700-4. German. PMID: 2144420 [PubMed - indexed for MEDLINE] <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstra ctPlus&list_uids=2144420> "Comparative Bioavailability of Eicosapentaenoic Acid and Docosahexaenoic Acid from Triglycerides, Free Fatty Acids and Ethyl Esters in Volunteers. The bioavailability of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) from triglycerides, free fatty acids and ethyl esters was investigated in 8 female volunteers in a randomized triple cross-over trial with baseline control. EPA/DHA was administered in capsules in form of triglycerides (1.68/0.72 g), free fatty acids (1.35/1.065 g) and ethyl esters (1.86/1.27 g). The resulting EPA/DHA plasma levels were determined and evaluated. The mean relative bioavailability of EPA/DHA compared to triglycerides was 186/136% from free fatty acids and 40/48% from ethyl esters. Maximal plasma levels were about 50% higher with free fatty acids and about 50% lower with ethyl esters as compared to triglycerides. The tolerability of the free fatty acids was much worse than that of triglycerides and ethyl esters. The main side effect was eructation." Lawson LD, Hughes BG. Absorption of eicosapentaenoic acid and docosahexaenoic acid from fish oil triacylglycerols or fish oil ethyl esters co-ingested with a high-fat meal. Biochem Biophys Res Commun. 1988 Oct 31;156(2):960-3. PMID: 2847723 [PubMed - indexed for MEDLINE] <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstra ctPlus&list_uids=2847723> "The absorption of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) from fish oil triacylglycerols and fish oil ethyl esters consumed in a high-fat meal (44 g total fat) by male volunteers was measured and compared to values previously reported for consumption in a low-fat meal (8 g total fat). Absorption of EPA, but not of DHA, from fish oil triacylglycerols was significantly improved from 69% to 90% by co-ingestion with the high-fat meal. Absorption of both EPA and DHA from fish oil ethyl esters was increased three-fold, to about 60%, by co-ingestion with the high-fat meal, indicating that absorption of fatty acid ethyl esters is highly dependent on the amount of co-ingested fat."  SignatureMatti Narkia > "The n-3 fatty acids from fish appear to be more efficacious, > in terms of cardioprotection, than equivalent amounts provided > as capsules. > Marked increments in plasma EPA and > DHA concentrations (microg/mg total lipid) and percentages of > total fatty acids were recorded at the end of treatment with > either n-3 capsules or salmon. Net increments of EPA and DHA in > plasma lipids were linearly and significantly correlated with > the dose after capsule administration. > n-3 fatty acids from fish are more > effectively incorporated into plasma lipids than when [quoted text clipped - 11 lines] > triacylglycerols correlates well with known in vitro pancreatic > lipase activity." > The mean relative bioavailability of EPA/DHA > compared to triglycerides was 186/136% from free fatty acids [quoted text clipped - 9 lines] > fat) . . . absorption of fatty acid ethyl esters is highly dependent > on the amount of co-ingested fat." Can anyone boil these abstracts down into a paragraph? I've read this post several times, and followed Google leads down several garden paths beginning with such things as fish oil and free fatty acids and triglycerides, and after 20-30 minutes am still not clear on it. I *think* that: 1. There are two types of fish oil supplements, a cheap one based on ethyl esters and a far superior one based on fish triglycerides. 2. Free fatty acids come directly from the consumption of salmon, and 3. are much more effective than even the good, triglyceride-based supplements. Thus 4. we should simply eat salmon daily rather than taking triglyceride fish oil supplements, but either one 5. beats the heck out of ethyl ester supplements. 6. The bottom line is probably that we should eat a little salmon almost every day (which contradicts previous studies) and take three high-quality, burp-free, triglyceride-based fish oil capsules on the days we don't eat salmon. And, oh yes, increase our fat consumption 5-10-fold (Uh, no thanks) to boost fatty acid absorption. How'd I do? Man, I get *SO* tired of trying to get to the roots of all this stuff. The process is fun, but A. It can devour our waking hours if we let it, B. There's so much controversy that much of it is ultimately a waste of time, C. Most of us have lives to get on with, and D. Wallowing in this stuff usually devours more time than it adds to our lives. I.P. >> "The n-3 fatty acids from fish appear to be more efficacious, >> in terms of cardioprotection, than equivalent amounts provided [quoted text clipped - 44 lines] >1. There are two types of fish oil supplements, a cheap one based on >ethyl esters and a far superior one based on fish triglycerides. Three types: free fatty acids, triglycerides and ethyl esters. >2. Free fatty acids come directly from the consumption of salmon, and From salmon we get triglycerides, not free fatty acids. In digestion lipase enzyme breaks down triglycerides into free fatty acids, which after the absorption are usually again joined into triglycerides. SignatureMatti Narkia >> "The n-3 fatty acids from fish appear to be more efficacious, >> in terms of cardioprotection, than equivalent amounts provided [quoted text clipped - 44 lines] >1. There are two types of fish oil supplements, a cheap one based on >ethyl esters and a far superior one based on fish triglycerides. Three types: free fatty acids, triglycerides and ethyl esters. >2. Free fatty acids come directly from the consumption of salmon, and' From salmon we get triglycerides, not free fatty acids. In digestion lipase enzyme breaks down triglycerides into free fatty acids, which after the absorption are usually again joined into triglycerides. >3. are much more effective than even the good, triglyceride-based >supplements. Free fatty acids (not from salmon, but from capsules) are absorbed better than triglycerides from capsules which are absorbed better than ethyl esters from capsules. >Thus >4. we should simply eat salmon daily rather than taking triglyceride >fish oil supplements, but either one Eating fatty fish has its advantages, because fish has other useful substances such as vitamin D, taurine, selenium, phosphatidylserine, etc., and unlike other proteins, fish protein may prevent insulin resistance, but triglycerides in fatty fish and triglyceride fish oil capsules are same, so there should not be much difference in their absorption rate, except that the other fat in fish may somewhat improve the absorption of omega-3 triglycerides from fish. Fish oil triglyceride supplements are IMHO ok for increasing omega-3 intake. I eat fish _and_ take triglyceride fish oil capsules. >5. beats the heck out of ethyl ester supplements. At least in bioavailability. Then there is that animal test, which found ethyl ester EPA's anticachetic and antitumor effect to be inferior to the comparable effects of free acid EPA. >6. The bottom line is probably that we should eat a little salmon almost >every day (which contradicts previous studies) and take three >high-quality, burp-free, triglyceride-based fish oil capsules on the >days we don't eat salmon. And, oh yes, increase our fat consumption >5-10-fold (Uh, no thanks) to boost fatty acid absorption. Increasing simultaneous fat consumption mainly affects the absorption of ethyl ester supplements. Its affect on triglyceride supplements is not that great. BTW, _healthy_ fat is not bad for cancer patients, because cancer cells cannot use fat as a source of energy, they depend mainly on glucose. In an animal test, animal model of brain cancer was stabilized by feeding them extremely low-carb high-fat diet containing 90% of calories as fat. That's too restrictive and unpalatable for most cancer patients, but for patients suffering from incurable brain cancer it may offer some promise in the future. With healthy fat I mean mostly monounsaturated fat from extra virgin olive oil, avocados, almonds, etc, and omega-3s from fish or fish oil. >How'd I do? > [quoted text clipped - 6 lines] >D. Wallowing in this stuff usually devours more time than it adds to our >lives. Well it's completely voluntary to read these posts and to reply to them ;-). Everyone should spend their time as they wish, IMHO. I enjoy searching and reading nutrition research, but I may be an exception ;-). I certainly don't feel that it had been waste of time for me, but some other might think so, we are all different. I cannot be sure, but I have a feeling that the knowledge about nutrition and application of that knowledge has probably saved my life at least once or twice. SignatureMatti Narkia > Well it's completely voluntary to read these posts and to reply to > them ;-). Everyone should spend their time as they wish, IMHO. I enjoy [quoted text clipped - 3 lines] > I have a feeling that the knowledge about nutrition and application of > that knowledge has probably saved my life at least once or twice. I enjoy it, too, and it has saved me from a lot of unnecessary grief, maybe even my life, too. But when reading leads me to diverging paths (*up* the oak tree) rather than down to a conclusion (down to the tree trunk), my returns diminish and my motivation wanes. I've been reading this omega 3 stuff for literally decades and still can't keep it straight even at the practical level, let alone the theoretical level. Maybe I waited until my brain function was beyond the help of the avocados and fish oil and extra virgin olive oil -- all of which I consume every day. And thanks for the clarifications. They help. I.P. > Sorry to intrude here again although I don't have PCa. But I'm a guy > and naturally a bit worried about getting PCa, and therefore check > this group now and then, I'm a cancer patient though, dxd with throat > cancer 18 years ago. I certainly do not mind the intrusion. But could you summarize? Are you saying, "eat fish, not capsules?" > I have my doubts about OMACOR's suitability for cancer patients. > According to [quoted text clipped - 149 lines] > that absorption of fatty acid ethyl esters is highly dependent > on the amount of co-ingested fat." >> Sorry to intrude here again although I don't have PCa. But I'm a guy >> and naturally a bit worried about getting PCa, and therefore check [quoted text clipped - 4 lines] > >Are you saying, "eat fish, not capsules?" No, I eat fatty fish _and_ take triglyceride fish oil capsules. There are three forms of fish oil capsules: free fatty acids, triglycerides, and ethyl esters. Ethyl esters have some advantages in manufacturing process and they are cheaper to make, therefore they are the dominant form in fish oil products. Bioavailability from the best to the worse is free fatty acids > triglycerides > ethyl esters, and that's also the order from the most expensive one to the cheapest one. Triglycerides are the form which appears in the fatty fish. According to one animal test anticancer and anticachectic effects of ethyl ester form are inferior to the free fatty acid form. So overall volume of evidence is not overwhelming, but if the main reason for using fish oil is its potential anticancer effects, why not to use products, which may in this respect to be better that ethyl ester form, i.e. either free fatty acid form, or triglyceride form. Triglyceride form is the natural form, but it's broken into free fatty acids by digestive enzyme lipase, so in a way free fatty acid form could perhaps also regarded as natural. The reason it is absorbed better than triglyceride form, is probably that it does not need to be broken down by lipase enzyme as triglycerides do. There may not always be enough lipase available, or the breakk-down could be incomplete for some other reasons resulting in the waste of a part of the oil. On the page <http://www.stopagingnow.com/newsletters/1243> Jean Carper writes in the chapter "The Real TRUTH About Fish Oil Supplements" as follows: "Real or Fake Fish Oil? Fact: Fish oil supplements come in two forms: the natural triglyceride form or the synthetically manipulated ethyl ester form. It is worth knowing which form you are buying; it is usually not on the label, but you can inquire of the manufacturer. The difference is important: 1. The triglyceride form of fish oil is natural--exactly the same form that is found in fish, in contrast with the ethyl ester form of fish oil, that does not occur in nature. 2. Leading worldwide experts in omega-3 fish oil, such as Artemis Simopoulos, M.D., president of the Center for Genetiucs, Nutrition and Health in Washington, D.C., recommend the natural triglyceride form of fish oil supplements as superior to the ethyl ester form. 3. Since it is natural, the triglyceride form of fish oil is more bioavailable and more efficiently utilized by the body, says much research. In one study, 68 of the EPA and 57 percent of the DHA in natural triglyceride omega-3 was absorbed by men, compared with only 20 and 21 percent of the ethyl ester form. In another study of women, the bioavailability of natural triglyceride type fish oil was double that of ethyl esters. Blood concentrations of EPA and DHA were 52 to 60 percent higher after taking natural triglyceride fish oil than after taking ethyl ester fish oil. It's apparent that the ethyl ester form of EPA and DHA cannot mimic the physiological activity of natural fish oil in the form of triglycerides, at least in the liver, concluded a recent study on animals. New Technology Vs. Old The modern way to purify and concentrate fish oil for supplements is to apply molecular distillation and other manufacturing processes, leaving the omega-3s in their natural most biologically active triglycerides form. Previously, manufacturers had to concentrate crude fish oils and flush out impurities by using chemicals or enzymes to cleave omega-3 from the natural triglycerides, then react it with alcohol (ethanol), creating unnatural ethyl esters. This outmoded trans-esterification process, say experts, is no longer necessary and produces a biologically inferior fish oil supplement. Some makers still claim ethyl ester is superior, but this is not supported by research, and most quality fish oil supplements are now natural triglycerides. Bottom Line: Follow common sense. Get the REAL fish oil, the one the fish makes itself, not one chemically modified in a laboratory and never found in a living fish." SignatureMatti Narkia > On Mon, 23 Apr 2007 11:07:57 -0700, "california_chief" > [quoted text clipped - 16 lines] > suggests that ethyl ester form of EPA is inferior to EPA as free fatty > acid in cancer: ... > -- > Matti Narkia Matti Thanks for the helpful post. I have been on DHA+EPA molecularly distilled from fish for for several years at 4,000 mg per day (yes it's expensive) - it has kept my bad cholesterol low and blood pressure low plus it helps with the mental impairment caused by androgen deprivation. Lud |
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