HD Lighthouse Contributing Editor's Comment: The doctors of the Harvard Medical School are our most trusted source of medical information. There is no mercury in fish oil capsules.

Two grams of EPA a day will fight HD and heart attacks. That is a lot of fish to eat every day. Filling in with fish oil capsules is safe. --Jerry
Posted to the HDL: 21 Jun 2003

Harvard On Fish
Fish vs. fish oil capsules

Can you skip the fish and get the same benefits from taking fish oil capsules? Nutrition researchers believe that the lion’s share of fish’s health value comes from two omega-3 fats, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). The many varieties of fish oil capsules now on the market contain these fats. Moreover, chemically, mercury can’t mix with fat, so fish oil capsules are mercury-free. And fish is expensive. Popping some fish oil capsules is a much cheaper way of getting your omega-3s. So why not skip the fish and just take the capsules?

Keeping the bad fat out

That’s not a good idea for several reasons. Eating fish elbows other less healthy foods off your plate. People who eat fish tend to eat less red meat and possibly less cheese — two potent delivery systems for saturated fat. Besides, as much as we might like to reduce healthy food to a couple of essentials, it often seems to be the medley that’s good for us. EPA and DHA probably are leading factors in fish’s health benefits, but there may be other (as yet unknown) helpful components as well.

Fish oil supplement	Price* per capsule/ packet	EPA + DHA** content per capsule/packet	Comments
Coromega Omega-3 Fish Oil Supplement	57¢	480 mg	Comes as sweet, orange-flavored cream sealed in packets. Not very appetizing to look at, but tasty enough and okay in yogurt. Claims to be more potent because of packaging.
GNC Fish Body Oils 1000 Deodorized	13¢	300 mg	To us, this "deodorized" capsule tasted the same as other capsules.
Nature Made Omega-3/ Omega-6 Fish Oil	8¢	360 mg	Cheapest capsule we sampled. Nice big bottle. Best value per mg of EPA + DHA.
Rite Aid Natural Fish Oil	8¢	300 mg	Same as GNC product without the "deodorized" claim.
Zone Perfect Omega 3	11¢	267 mg	Bills itself as "molecularly distilled" to remove contaminants like PCBs. Recommended serving size is 4 capsules, twice the usual 2, so there are only 30 servings in the bottle.
*    Price when purchased from Drugstore.com on Dec. 20, 2002. Shipping costs not included. **  EPA = Eicosapentaenoic acid, DHA = Docosahexaenoic acid

Keeping the mercury low

If you’re worried about mercury, eating a variety of types of fish will keep your overall exposure low. Also keep in mind that mercury at the levels found in fish is most hazardous to the developing nervous system — which is why the current advisories are targeted at pregnant and breast-feeding women and young children. Current evidence indicates little, if any, risk to the fully developed adult nervous system from fish consumption.

Some research, though, has hinted at a connection between mercury and heart disease. Two large studies that might have helped settle the matter — but didn’t — were published in the Nov. 28, 2002, New England Journal of Medicine. One, from Johns Hopkins, found a correlation between mercury exposure (measured by testing toenails for the metal) and heart attacks. The other, from Harvard, found a correlation between fish consumption and mercury exposure (also tested in toenails), but no connection between mercury levels and heart disease.

Fishy claims on capsules

One problem with depending on fish oil capsules is that you don’t know what you’re buying. In researching this article, we talked to William S. Harris, the laboratory director of the St. Luke’s Lipid and Diabetes Center in Kansas City, Mo. Harris, who helped write the American Heart Association’s scientific statement on fish and fish oil consumption published late last year, sees little downside to fish oil and thinks the association’s endorsement could have been stronger. (The statement says that a food-based approach to omega-3s is preferred but adds that people with heart disease "could consider" capsules in consultation with a physician.) But Harris also told us that his lab has tested capsules that contained only half the amount of omega-3s listed on the label. And because fish oil capsules are supplements, they largely escape regulation by the FDA.

The bottom line

If all you want is EPA and DHA, it doesn’t seem to matter whether you eat fish or take fish oil capsules. The oblong capsules are sizable, so you might have to gulp them down with some water. Harris says that freezing them sometimes helps with the fishy aftertaste. But the human body and appetite are designed for food, not capsules. Most people are likely to be better off in the long run if they eat plenty of the whole fish, not just the oil. # # # HDL On Fish Oil

Source: Adopted from Harvard Health Letter, March 2003

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