Diet:

Both plants and animals can make the parent fatty acid of Ω-9 (oleic acid), but only plants can make Ω-3 (α-linolenic acid) and Ω-6 (linoleic acid) parent fatty acids.  Therefore in animals these FA are essential and must be obtained from the diet. 

             Sources of PUFA

Populations with high dietary intake of fish such as Greenland and Eskimos have a low incidence of inflammatory and auto-immune disorders, such as RA.

Table 3. -3 Content in Fish (Cooked, Dry Heat)^*

Fish EPA & DHA (mg per 100 g of edible fish; ~3–4 oz.) Herring 1700 Salmon 1600 Mackerel|| 1400 Flounder 500 Halibut¶ 500 Tuna** 300 Bluefin 1500 Canned white 900 Canned light 300 Cod 200 Catfish 200 Haddock 200

EPA and DHA; EPA=20:5 -3; DHA=22:6 -3.

Average; Atlantic and Pacific.

Average; Atlantic (wild and farmed), Chinook, pink, coho.

^|| Average; Atlantic, Jack; Pacific, Spanish.

^¶ Greenland halibut, 1100 mg.

^** Skipjack/yellowfin, 300 mg.

Adapted from: Practical Applications of Fish Oil (Ω-3 Fatty Acids) in Primary Care

Supplementation:   

Fish oil supplements provide the most consistent way of supplying higher doses of -3 FA. An alternative to dietary intake for persons who are unable to consume a fish-enriched diet include supplementation, which may also be lower in mercury content and other environmental pollutants. Most preparations provide approximately 300 mg of total -3 FA, divided between EPA and DHA.  Consumers are cautioned to buy from reputable and reliable brands because the FDA does not regulate supplements.  An independent, nonprofit organization that verifies manufacturing, quality, and purity claims of supplements is the United States Pharmacopeia (USP). Those supplements branded as USP may improve its reliability and safety.

Brand Amount of EPA & DHA (mg per capsule) Cost* ($) Number of capsules per day Web Site GNC Fish body oil 180/120 6.00 3–4 http://www.drugstore.com Natrol Omega-3 complex 180/120 6.00 3–4 http://www.drugstore.com Twinlab Omega-3 234/125 15.00 3 http://www.drugstore.com Mega Twin EPA 600/240 15.00 1–2 http://www.drugstore.com OmegaRx 400/200 25.00 2 http://www.zonenetonline.com/fishoil_detail.asp?realname= Ultimate Omega 350/250 26.95 2 https://www.nordicnaturals.com/direct/prodsummary.asp?ID=30 TriOmega 500 (total) 20.00 2 http://www.triomega.com Kirkland Fish Oil 180/120 5.00 3–4 http://www.costco.com Nature Made Fish Oil 216/144 7.00 3–4 http://www.drugstore.com

^* 1-month supply, supplying 1 g of EPA/DHA.

Pharmaceutical grade or makes claim regarding manufacturing process.

United States Pharmacopeia-branded.

Adapted from: Practical Applications of Fish Oil (Ω-3 Fatty Acids) in Primary Care

Dosing:

A dose response relationship exists up to a daily dose of 2.6 grams of fish oil, which is equivalent to about 1.6 grams of EPA.  Anti-inflammatory effects have been shown between 2.6 g/day and 7.1 g/day during therapy of 12 weeks or longer.  Ninety mg/kg/day EPA/DHA (3:2 ratio) is associated with a shorter period to response than 45 mg/kg/day.  Thus, high doses may be considered for loading with lesser does in the anti-inflammatory range for maintenance.

• Capsules are supplied in 400 mg, 500 mg, 1000 mg, 1200 mg, and 2000 mg preparations.

Trade Names: 

Fish oil is available generically from numerous manufacturers. Branded products include MaxEPA, Super EPA, Omega 3 (several manufacturers), Sof-Gel E.P.A. (Tyson Neutraceuticals), Marine Lipid Concentrate (Vitaline), Formula 3/6/9 (Advanced Nutritional), Prolinic (Key Company), Sam-E.P.A. (Bio-tech Pharmacal), Sea Omega (Rugby), Twin-EPA (Twinlab), Ultra 30/20 (Health From the Sun), Norwegian Fish Oil (Spectrum Naturals).